Aerobic exercise may be most effective for relieving depression/anxiety symptoms

 But all forms of exercise are as good as, or better than, medication and talking therapies, regardless of age or sex, the findings indicate.

Depression and anxiety affect up to 1 in 4 people worldwide, with the highest prevalence among young people and women, note the researchers. And previously published research suggests that exercise compares favourably with psychotherapy and medication for easing the symptoms, they add.

But it’s not clear how well exercise might work at different ages, frequency, and intensities.And previous overarching syntheses have focused only on adults or included participants with potentially influential factors, such as long term conditions.

The researchers therefore set out to comprehensively estimate the impact of exercise on depression and anxiety symptoms across all age ranges, including in those with and without a clinical diagnosis; and to find out whether the type, length, frequency, intensity, and supervision of exercise, and individual or group participation might influence outcomes.

They scoured research databases for pooled data analyses of randomised controlled trials that compared exercise with either another type of activity, or a placebo, or no active intervention, and published in English up to July 2025.

Eligibility criteria included planned, structured, repetitive and purposeful physical activities to improve physical and mental health; and all forms, intensities, frequencies and settings (individual or group) of exercise.

For depression, 57 pooled data analyses, comprising 800 component studies, involving 57,930 participants aged between 10 and 90, were included in the overarching synthesis.

These participants had been diagnosed with clinical depression or were experiencing depressive symptoms, but had no other co-existing conditions. Exercise interventions were categorised as aerobic (19 pooled data analyses); resistance, such as strength training (8); mind–body, such as yoga, tai-chi, and qigong (16); or a mix (39).

For anxiety, 24 pooled data analyses, comprising 258 component studies, involving 19,368 participants, aged between 18 and 67, were included in the overarching synthesis. Exercise interventions were categorised as aerobic (7); resistance (1); mind–body (9); or mixed (13).

Synthesis of the pooled data analyses showed that exercise had a medium sized effect on depression symptoms and a small to medium sized effect on anxiety symptoms, with the most substantial effects found for young adults (18-30) and women who had recently given birth.

All forms of exercise were associated with positive effects, with aerobic, group based and supervised formats the most effective for relieving depression symptoms. Aerobic, resistance, mind–body and a mix of different exercise formats had a medium sized impact on the relief of anxiety symptoms.

The effects were on a par with, or better than, medication or talking therapies.

The researchers acknowledge some limitations to their findings. These include the variable interpretations of exercise intensity and length among the pooled data analyses, and the relative paucity of pooled data analyses on the impact of exercise across the lifespan.

But they nevertheless conclude: “This meta-meta-analysis provides robust evidence that exercise effectively reduced depression and anxiety symptoms across all age groups, comparable with, or exceeding, traditional pharmacological or psychological interventions.

“Group and supervised formats gave the most substantial benefits, underscoring the importance of social factors in mental health interventions. With evidence that different characteristics of exercise appear to impact depression and anxiety at varying magnitudes, tailored exercise programmes must be prescribed.”

They continue: “Given the cost effectiveness, accessibility, and additional physical health benefits of exercise, these results underscore the potential for exercise as a first line intervention, particularly in settings where traditional mental health treatments may be less accessible or acceptable.”

Reference

https://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2025-110301